Opioid Prescriptions and Pain-Related Patient-Initiated Communication After Mohs Micrographic Surgery: A Retrospective Cohort Study

Background: There is a wide variety in utilization of opioids during Mohs Micrographic Surgery (MMS) despite evidence that a multimodality approach may be more beneficial. Objective: To evaluate prescription opioid use at our institution and subsequent pain-related patient communication following MMS. Methods: This was a retrospective cohort study involving 2360 patients who underwent MMS. Patient and operative characteristics in relation to opioid use in the peri-operative period were compared using univariate and bivariate statistical measures. Results: A total of 306 patients (13%) were prescribed opioids postoperatively. However, receipt of opioids is associated with greater odds of pain-related patient communication (OR=6.2; 95% CI:3.3-11.4). Opioid type was not significantly associated with reported pain (OR=0.7; 95% CI:0.3-1.8). Conclusion: Consistent with existing guidelines, certain patient and operative characteristics such as age, number of Mohs stages, repair type, and anatomic site were associated with greater odds of receiving opioids. While certain patients may require opioids for adequate pain control, in our cohort, opioid use was associated with increased odds of pain-related patient communication post MMS.